Folic acid

Folic acid

DEFINITION
Folic acid belongs to the B group of vitamins and is the
supplemental form of folate. Folic acid plays an essential role in
human growth and development, in particular cell division and DNA
synthesis. The demand for Folic acid increases when human cell
growth is very active, such as in pregnancy, during breastfeeding
and some types of cancer e.g., leukaemia.
MEDICAL USE
Always consult your Health Professional to advise you on
dosages. Folic acid is important for any stage of human life which
involves growth such as pregnancy, lactation and early growth
because of the role the folate plays in DNA, RNA and protein
production.
Folate and Pregnancy
Folic acid deficiency is strongly linked with the risk of
having an infant with spina bifida or other neural tube defects
(NTD). Folic acid supplements should be taken daily for three
months before conception and during the first trimester. Women who
have a family history of neural tube defects or who have had a baby
with a neural tube defect should take 5mg of folate daily and other
women should take 0.4mg of folate daily. 
Dosages
To prevent NTDs 400 mcg (0.4 mg) is required per day from at
least one month before conceiving and for the first three months of
pregnancy. Most single supplements contain 400 mcg per tablet,
therefore one tablet per day is usually adequate. Multi-vitamins,
however, may not contain sufficient amounts of Folic Acid so it is
important to read the label. In women who have already had an
NTD-affected pregnancy or a family history of the problem, the
recommended daily dose of Folic acid is much higher. Any dose above
1 mg, however, should only occur after advice from and supervision
by a medical Doctor. See your health care professional for advice
about the correct dosage for you.
DEFICIENCY
Folic acid deficiency is one of the most common nutritional
deficiencies and has been observed in alcoholics, pregnant women,
people living in institutions e.g. nursing homes, people with
absorption problems such as ulcerative colitis and people taking
certain medications e.g., methotrexate. In most cases a Folic acid
deficiency occurs without any symptoms. In severe cases of Folic
acid deficiency signs and symptoms such as macrocytic anaemia,
weakness, tiredness, irritability, forgetfulness, difficulty
breathing, anorexia, diarrhoea, weight loss, headache, palpitations
and inflammation of the tongue may occur.
SOURCES
Certain foods are now enriched with folate to provide a higher
dietary intake e.g., some breakfast cereals, juices and most bread
(bread made with organic flour may not contain folate) Foods which
are good sources of folate include; dark green, leafy vegetables,
many fruits (especially berries, oranges and bananas), nuts,
cereals, dried peas, beans, lentils and eggs. Food processing,
storage, preparation and cooking can also destroy up to half of the
total folate content of vegetables. Steaming or lightly stir frying
vegetables is the best way to preserve the folate content.
NOTES
Folic acid is not recommended for people taking anticonvulsant
medication. Folic acid may lower plasma phenytoin or phenobarbital
concentrations. Taking more than 10 mg of Folic acid daily may lead
to reduced seizure control in patients suffering from epilepsy.
Women with epilepsy should possibly avoid high doses as it may
trigger convulsions. 
Doses of more than 4 mg of Folic acid per day may mask the effects
of vitamin B12 deficiency leading to neurological damage. There are
certain drugs that may interfere with folate levels in the body.
Your Pharmacist can advise about possible Folate/medication
interactions.